Participants:
Acutely febrile patients from the northeastern United States in whom
the treating health care providers suspected and ordered testing for
tick-transmitted infections.

Measurements:
Whole-blood polymerase chain reaction (PCR) testing was performed for
the presence of specific DNA sequences of common tickborne infections
(including BMD). Serologic testing for B. miyamotoi was performed
using a recombinant glycerophosphodiester phosphodiesterase (rGlpQ)
protein. Clinical records were analyzed to identify the major
features of acute disease.

Results: Among 11
515 patients tested, 97 BMD cases were identified by PCR. Most of the
51 case patients on whom clinical histories were reviewed presented
with high fever, chills, marked headache, and myalgia or arthralgia.
Twenty-four percent were hospitalized. Elevated liver enzyme levels,
neutropenia, and thrombocytopenia were common. At presentation, 16%
of patients with BMD were seropositive for IgG and/or IgM antibody to
B. miyamotoi rGlpQ. Most (78%) had seropositive convalescent
specimens. Symptoms resolved after treatment with doxycycline, and no
chronic sequelae or symptoms were observed…

Conclusion: Patients
with BMD presented with nonspecific symptoms, including fever,
headache, chills, myalgia, and arthralgia. Laboratory confirmation of
BMD was possible by PCR on blood from acutely symptomatic patients
who were seronegative at presentation. Borrelia miyamotoi disease may
be an emerging tickborne infection in the northeastern United States.